CONSERVATIVE MANAGEMENT OF PITUITARY TUMOR APOPLEXY: TWO CASE REPORTS.

Pituitary tumor apoplexy is a rare neuroendocrine syndrome, resulting, in most cases, from hemorrhage or infarct of a pre-existing pituitary adenoma. Treatment recommendations vary; some authors advocate urgent surgical decompression of the tumor, whereas others suggest that conservative management can lead to recovery of neuro-ophthalmologic function. We describe two patients with pituitary tumor apoplexy who had clinically non-functioning macroadenomas and hypopituitarism, including hypogonadism. They were treated conservatively without surgery and achieved tumor remission. Apoplexia de um tumor hipofisario e uma sindrome neuroendocrinologica rara, resultante na maioria dos casos de uma hemorragia ou infarto de um adenoma pre-existente. As recomendacoes quanto ao tratamento variam; alguns autores recomendam uma descompressao cirurgica urgente do tumor, enquanto outros sugerem que o tratamento conservador pode levar a recuperacao da funcao neuro-oftalmologica. Nos descrevemos dois pacientes com apoplexia de um tumor hipofisario que apresentavam macroadenoma clinicamente nao funcionante e hipopituitarismo, incluindo hipogonadismo. Eles foram tratados conservativamente, sem cirurgia, e obtiveram remissao tumoral.